Coronavirus and Its Impact

[Golfman25 5,019]

47 minutes ago, mdn82 said:

We are looking at June to July and that’s from the government instruction. We are a financial institution so I would guess we will be one of the first industries back. But I think one misconception I tried going into more early on and was repeatedly corrected on my numbers and explanations from the CDC “if I even talked to them” this was never about mortality rate. It’s about the overwhelming effect of amount versus chain supply/supply and how many rooms we had.

Anybody that has worked in healthcare can tell you in most healthcare systems we had atleast 25% more beds 20 years ago. A couple of things have changed to massively decrease that. Health systems were mostly just started about 20 years ago. 30 years ago they were non existent. I am going to use northern Indiana because it’s where I live. You had Lutheran and you had Parkview 25 years ago. Then you had area hospitals. With the rising cost of supplies for various political reasons those Parkviews and Lutheran started buying up area hospitals in the late 80s/early 90s. The big hospitals could get better prices as could the area hospitals. About 20 years ago when there were health systems they decided its best to have one hub (Parkview Regional Medical Center), and the area hospitals then feed into that one. The area hospitals were outpatient mostly facilities whereas PRMC became the critical care facility. Parkview has Wabash, Huntington, Randallia (opened up again due to shortages), warsaw, Whitley, Noble, LaGrange, and Dekalb. Out of all of those there is less than 50 CCU beds. In those hospitals you will be lucky if you have 5 ventilators. When the bigger hospitals get inundated those supplies stay at the big hospital. Now these hospitals can expand. But between those two health systems which is northern Indiana there are less than 500 CCU rooms. Can that cover northern Indiana?

Long winded response to say this has nothing to do with mortality rate. It has to do with transmission rate and the toll it is taking on our supply system and structure. In hospitals they will have to decide soon (already here in NYC) if they are saving you or the 70 year old healthcare worker. In some instances neither because they don’t have a ventilator to keep you from drowning.

At least in IL, the ability to build a hospital is all politics.  So it's extremely difficult.  Stocking those hospitals from foreign sources has proven deadly.  

[Old Friend 8,389]

1 hour ago, cthomas said:

I fully understand what you are saying and agree that has driven our response. The "just in time" economic model prevents us from being prepared for global events like this. Given the economic implications, I doubt that we will add permanent capacity to deal with the occasional crisis. Mortality drives the optics presented in the media with one sad story after another fueling emotional responses over rational ones.. I'm in the high risk group, so I'm not downplaying the seriousness of this virus. And the next time, and there will be a next time, the mortality rates might be much higher and the optics much worse. What I saying is that we need a rapid response infrastructure that does not include a permanent increase in hospital capacity or costly inventories. I believe that such a thing is possible. I just don't know if we have the will. Sometimes as I watch this unfold, I think we are so busy looking at the trees that we don't see the forest.

I saw a post on Twitter today that said this is going to make everybody take a hard look at political correctness, special interests, "just in time" needs for everything - including information, corporatization, etc.. and make some of those initiatives seem petty and insignificant.  God, I hope so.    I was in medical sales for 20 years beginning in 1994 or so.  When I started?  St. Vincent hospital had 3 campuses.  The mother ship on the north side of Indy, Carmel, and a small hospital in Brazil, IN.  When I got out, they owned 47 campuses.  Selling became corporate and based solely on pricing.  No care-based rationale and no relationships.  Contract driven medicine based on purchasing power.

That's not Donald Trump's fault. That's not Barack Obama's fault.  That's not George Bush's fault.  It's systemic.   But the answer is not state control or whatever it is Gavin Newsom said today.  The government was set up of the people and for the people.  And the people are the ones stepping up to solve problems.  Our issue?  There are no term limits.  There are hundreds of professional politicians with no life experience, and the people leading our country right now from a medical perspective (Dr. Fauci in particular) have no understanding of the economic catastrophe which would be caused by his recommendations of "not opening up the country until we have a vaccine....in a year and a half."   Or really what's happening out there.  He has tunnel vision, and said yesterday therapies aren't his top priority.  I get that testing and finding out who's infected is his priority, but damn, dude...the country needs to turn the lights back on, too.  You can manage two priorities simultaneously!  

I do think this will create a better system for rapid response, and I think American manufacturing will play a huge role as long as leadership in Washington  promotes and permits it.  If we start to gravitate more toward state control?  We're doomed.  In my mind, it's as simple as that.  I trust business people and American ingenuity over elected officials every time.

[mdn82 25,510]

At least in IL, the ability to build a hospital is all politics.  So it's extremely difficult.  Stocking those hospitals from foreign sources has proven deadly.  

Agreed. I know our supply chain was constantly saying this exact scenario would be the worst case scenario after they started decommissioning both inpatient and CCU. When I was at Parkview we did a risk analysis that determined where we were and where we were going. That was mainly due to us getting Randallia back, and building a new hospital in Wabash. Wabash went from a multi story hospital with over 100 beds, down to a hospital with 26 beds, no OB, and only 6 that went as CCU beds. They can convert more but that’s the norm when these larger Health Systems took over due to pricing. Well that and they got full control of their patient list. If we had enough beds, ventilators, and anti inflammatory meds, IV, and PPE the death rate would be even lower with the measures we are taking. I hope this avoids northern Indiana to the degree of spread it has had elsewhere. It should as our population density isn’t near theirs. But if it starts spreading in some of these rural areas where this type of health system and setup is the norm or healthcare workers start getting sick, say a prayer. That’s all we can do beyond what is being asked of us.


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[Golfman25 5,019]

14 minutes ago, mdn82 said:

Agreed. I know our supply chain was constantly saying this exact scenario would be the worst case scenario after they started decommissioning both inpatient and CCU. When I was at Parkview we did a risk analysis that determined where we were and where we were going. That was mainly due to us getting Randallia back, and building a new hospital in Wabash. Wabash went from a multi story hospital with over 100 beds, down to a hospital with 26 beds, no OB, and only 6 that went as CCU beds. They can convert more but that’s the norm when these larger Health Systems took over due to pricing. Well that and they got full control of their patient list. If we had enough beds, ventilators, and anti inflammatory meds, IV, and PPE the death rate would be even lower with the measures we are taking. I hope this avoids northern Indiana to the degree of spread it has had elsewhere. It should as our population density isn’t near theirs. But if it starts spreading in some of these rural areas where this type of health system and setup is the norm or healthcare workers start getting sick, say a prayer. That’s all we can do beyond what is being asked of us.


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I think rural areas will be fine if they just stay out of group settings.  Albany Ga. got a real bad case because they had something like 200 people attending a funeral, kissing and hugging and what not.  It overwhelmed their small hospital.  

[cthomas 6,325]

26 minutes ago, Old Friend said:

I saw a post on Twitter today that said this is going to make everybody take a hard look at political correctness, special interests, "just in time" needs for everything - including information, corporatization, etc.. and make some of those initiatives seem petty and insignificant.  God, I hope so.    I was in medical sales for 20 years beginning in 1994 or so.  When I started?  St. Vincent hospital had 3 campuses.  The mother ship on the north side of Indy, Carmel, and a small hospital in Brazil, IN.  When I got out, they owned 47 campuses.  Selling became corporate and based solely on pricing.  No care-based rationale and no relationships.  Contract driven medicine based on purchasing power.

That's not Donald Trump's fault. That's not Barack Obama's fault.  That's not George Bush's fault.  It's systemic.   But the answer is not state control or whatever it is Gavin Newsom said today.  The government was set up of the people and for the people.  And the people are the ones stepping up to solve problems.  Our issue?  There are no term limits.  There are hundreds of professional politicians with no life experience, and the people leading our country right now from a medical perspective (Dr. Fauci in particular) have no understanding of the economic catastrophe which would be caused by his recommendations of "not opening up the country until we have a vaccine....in a year and a half."   Or really what's happening out there.  He has tunnel vision, and said yesterday therapies aren't his top priority.  I get that testing and finding out who's infected is his priority, but damn, dude...the country needs to turn the lights back on, too.  You can manage two priorities simultaneously!  

I do think this will create a better system for rapid response, and I think American manufacturing will play a huge role as long as leadership in Washington  promotes and permits it.  If we start to gravitate more toward state control?  We're doomed.  In my mind, it's as simple as that.  I trust business people and American ingenuity over elected officials every time.

I agree that the political system is completely broken right now. Political agendas drive virtually everything and both political parties are to blame. We need a government with a long term vision to solve big problems, ideally with public and private partnerships. The fact that we haven't been able to do that for some time results in the kind of mess we are in right now.

[RaceToTheTop 24,959]

Indiana schools officially will not be open for the remainder of the school year.  Students will have remote instruction only for the rest of the year and the number of instructional days is dropped from 180 to 160.  Most schools will end their year by the end of April.

[Old Friend 8,389]

1 hour ago, cthomas said:

I agree that the political system is completely broken right now. Political agendas drive virtually everything and both political parties are to blame. We need a government with a long term vision to solve big problems, ideally with public and private partnerships. The fact that we haven't been able to do that for some time results in the kind of mess we are in right now.

Yep.  As recently as the 1980's, there was overlap.  The furthest left republicans overlapped with the furthest right democrats and we could govern in the middle.   That's not true now. 

Not to make this a political narrative, but a large group of people in politics drifted away to a place where political power and agenda trumped (no pun intended) what works in a representative republic dependent on capitalism.   And with no common ground (I believe, for example that there isn't one thing on which Jerry Nadler and Pete Sessions would ever agree.   And that's a problem.  They will always fight each other, and not for the American people, but for their ideology.  Neither ideology is absolutely correct, but I favor one over the other because I'm pro-capitalism/anti-big government, and when I see what's happening right now in the private sector, I am validated in MY opinion.   But that's my opinion.  

The problem is there will always be a gap in income and class; but much of that depends on things like risk, education, and work.  Some does not, and some have benefitted from abuse of the system, greed, etc.  That is true, so absolutely some changes need to be made, but until there are term limits, it won't happen.  I heard a suggestion yesterday for a 1-term, 6 year presidency and 1-term 4 year senate seats to go along with 2 year house seats which could be no longer than 2 terms.   I sort of liked it.  

[8bucks 6,352]

Yep.  As recently as the 1980's, there was overlap.  The furthest left republicans overlapped with the furthest right democrats and we could govern in the middle.   That's not true now. 
Not to make this a political narrative, but a large group of people in politics drifted away to a place where political power and agenda trumped (no pun intended) what works in a representative republic dependent on capitalism.   And with no common ground (I believe, for example that there isn't one thing on which Jerry Nadler and Pete Sessions would ever agree.   And that's a problem.  They will always fight each other, and not for the American people, but for their ideology.  Neither ideology is absolutely correct, but I favor one over the other because I'm pro-capitalism/anti-big government, and when I see what's happening right now in the private sector, I am validated in MY opinion.   But that's my opinion.  
The problem is there will always be a gap in income and class; but much of that depends on things like risk, education, and work.  Some does not, and some have benefitted from abuse of the system, greed, etc.  That is true, so absolutely some changes need to be made, but until there are term limits, it won't happen.  I heard a suggestion yesterday for a 1-term, 6 year presidency and 1-term 4 year senate seats to go along with 2 year house seats which could be no longer than 2 terms.   I sort of liked it.  

I agree. The political divide seems wider than any point I can remember. I would strongly be in favor or getting rid of the idea of career politicians. It is too bad because too much turnover, which term limits will create, will lead to inefficiency. However, we need people in those roles that have spent more time working or serving outside of politics than they have spent in politics.


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[Brass Cannon 24,248]

54 minutes ago, 8bucks said:

I agree. The political divide seems wider than any point I can remember. I would strongly be in favor or getting rid of the idea of career politicians. It is too bad because too much turnover, which term limits will create, will lead to inefficiency. However, we need people in those roles that have spent more time working or serving outside of politics than they have spent in politics.


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I’ve always felt Senators should be limited to one elected term. And no more than 10 total years. And then let the house be 10 total years. That way the house isn’t losing too many people any given year and. And with fresh candidates every year in the senate you might have little experience but you’ll probably have a lot of people that were already in the house for 10 years trying to work their way up. 

[Old Friend 8,389]

1 hour ago, 8bucks said:

I agree. The political divide seems wider than any point I can remember. I would strongly be in favor or getting rid of the idea of career politicians. It is too bad because too much turnover, which term limits will create, will lead to inefficiency. However, we need people in those roles that have spent more time working or serving outside of politics than they have spent in politics.


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This is precisely why Trump won 4 years ago.

[Old Friend 8,389]

52 minutes ago, Brass Cannon said:

I’ve always felt Senators should be limited to one elected term. And no more than 10 total years. And then let the house be 10 total years. That way the house isn’t losing too many people any given year and. And with fresh candidates every year in the senate you might have little experience but you’ll probably have a lot of people that were already in the house for 10 years trying to work their way up. 

Can't have house terms be 10 years.  Way too much can change from district to district, which is why the term is 2 years.  Demographics can change in a few months as different counties adjust and zone for different things, tax bases change.  Hell, a guy/gal who was elected to represent District 5 in Indiana has a completely different landscape now than 10 years ago.  It's not even recognizable time period over time period.

[Brass Cannon 24,248]

23 minutes ago, Old Friend said:

Can't have house terms be 10 years.  Way too much can change from district to district, which is why the term is 2 years.  Demographics can change in a few months as different counties adjust and zone for different things, tax bases change.  Hell, a guy/gal who was elected to represent District 5 in Indiana has a completely different landscape now than 10 years ago.  It's not even recognizable time period over time period.

Not a term of 10 years. Let them serve for 10 years. 

[Golfman25 5,019]

1 hour ago, Brass Cannon said:

Not a term of 10 years. Let them serve for 10 years. 

That would be 5 x 2 year terms.  :)

 

[Lebowski 2,443]

That's great y'all are talking about politics but COVID-19 doesn't give a poop.  Science doesn't care whoever is in control to make the leadership decisions.  Science will always expose leadership whether that be good or bad.  Always. 

The entire world is dealing with infection rates that health care systems are struggling to manage.  The value of early testing is abundantly clear.  Hopefully leadership will understand this and implement something for the future. 

What's unfortunate, to get back on the political train, is that depending on which team you cheer for will either dismantle or reassemble whatever decision is decided to implement.  

 

[Defenserocks28 393]

On 4/2/2020 at 12:32 PM, Golfman25 said:

At least in IL, the ability to build a hospital is all politics.  So it's extremely difficult.  Stocking those hospitals from foreign sources has proven deadly.  

What's more ridiculous about this is that we actually shipped a TON of our own supplies to foreign countries, as recently as February, even though it was clear by that point Covid-19 was going to be a true challenge for any nation to deal with.  

This article is just fantastic in showing the utter ineptitude of how the U.S. government is dealing with this crisis.  Truly worth the five minute read if you have time:

https://heathercoxrichardson.substack.com/p/april-1-2020

Also, we can't test anyone because only 3 of 100 public health labs were operational due to budget cuts (not to mention the elimination of virtually all programs associated with finding new pandemic threats and response teams):

https://fortune.com/2020/02/26/coronavirus-covid-19-cdc-budget-cuts-us-trump/

Clearly the budget cuts were worth it though so we could cut corporate taxes and Delta, United, American etc and other corporations could fund stock buybacks. 

The news broke that the United States has been sending medical supplies to other countries while our own health care workers don’t have masks or PPE (personal protective equipment). Politico revealed that an administration official called counterparts in Thailand to ask for PPE only to be told by a confused official on the other end who said that the U.S. was shipping those very supplies to Thailand. One shipment had already arrived, and another was on its way. Vice President Mike Pence, who is in charge of the administration’s coronavirus task force, immediately halted the shipment. It appears that there has been no coordination between the administration and USAID, the United States Agency for International Development, so we have apparently been exporting the very supplies we need at home.

This created a furor over the fact that we also sent 17.8 tons of medical supplies, including masks, gowns, gauze, and respirators to China in February, after the severity of our own impending crisis was already clear. The administration has said these supplies were “donated,” but I have not been able to track down by whom.

And This:

We learned that the Obama administration tried five years ago to address what it perceived as a lack of ventilators in case of a pandemic, paying $13.8 million to a Pennsylvania manufacturer—a subsidiary of a huge Dutch appliance and technology corporation-- to create a cheap, easy ventilator to stockpile. The FDA cleared the device in September and the Department of Health and Human Services, which had provided the $13.8 million, ordered 10,000 of them for $3,280 each. Instead of providing those ventilators, the company instead hiked its prices and sold them overseas. Trump has declined to use the DPA to get the company to produce the ventilators it developed for the U.S. Instead, Kushner’s team is negotiating with it to build 43,000 more expensive hospital ventilators for the U.S.

[Stuhoo 79,752]

I thought this article was interesting because, while not yet peer reviewed, it is a scientifically backed University research paper predicting the peak day for cases and deaths nationally and in each of the 50 states:

https://thehill.com/changing-america/well-being/prevention-cures/490856-when-will-coronaviruses-cases-peak-in-your-state

[Napleshoosier 10,139]

Now for the important stuff, it’s Friday happy hour time at home! Drink up!


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[BlueDevil 8,655]

I thought this article was interesting because, while not yet peer reviewed, it is a scientifically backed University research paper predicting the peak day for cases and deaths nationally and in each of the 50 states:
https://thehill.com/changing-america/well-being/prevention-cures/490856-when-will-coronaviruses-cases-peak-in-your-state

This makes me feel a lot better honestly


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[ALASKA HOOSIER 11,256]

Well, i guess i can put this out there. in case some of you noticed,I have been spotty, at best with keeping up with the game predications and responding to fellow btowners. To be honest, i have been in an austere local for the past 7 months doing some good stuff to some bad people and recently got evacuated back to Alaska until this weirdness clears up (just in time to prepare for the salmon run). Didn't mean to ignore the majority of you (except Natty, Aloha, nips and the really old fart) but I'm back on here to join in all the online festivities! In case anyone is wondering: Alaska got hit hard with the virus by a cargo plane from China back in early March. We now have like 130ish (can't remember the numbers) with over 30 here in my small tight-knit community of Fairbanks *doesn't sound like a lot but it is for us since we have just a few stores we all frequent* Personally, I'm prepped up with everything i need to keep from going to town but i know eventually, I'm gonna get this Purdue person as will most Fairbanksians. We have only one main hospital in the area and i know it's at it's capacity with only 30+ folks infected. Hopefully, we can keep the infection rate steady to not completely overwhelm the health system. But you know what... I'm disappointed in this pandemic. Where the hell are the zombies? ah... maybe next time.

[Hovadipo 55,122]

I’ve never simultaneously thought someone was as funny and mysteriously terrifying as Alaska Hoosier. Never change my man.